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This study investigated the clinicopathologic factors associated with 2-[F]fluoro-2-deoxy-D-glucose (F-FDG) uptake of early gastric cancer (EGC) and used them to design a clinical scoring method to predict FDG-avidity of EGC.Two hundred twenty-nine retrospectively enrolled patients underwent preoperative F-FDG positron emission tomography/computed tomography (PET/CT). Histologic information was obtained by gastrectomy (n = 195) or endoscopic mucosal dissection (n = 34). The association between clinicopathologic factors and F-FDG uptake by the primary tumor was determined. The results were used to develop a clinical scoring method.F-FDG uptake was detected in 49 (17.5%) patients. According to univariate analysis, location, gross type, World Health Organization classification, Lauren classification, size, depth of invasion, and lymphatic invasion were significant variables affecting F-FDG uptake (all P < .05). According to multivariate analysis, location (lower 3rd, P = .035), gross type (0-I, 0-IIa, P < .001), size (≥2.5 cm, P = .026), and depth of invasion (submucosa, P = .007) were significantly associated with FDG-avidity. A clinical scoring system, ranged from 0 to 4, was developed by giving one score to 4 independent variables. A cut-off value of 2.5 showed good prediction of FDG-avidity in EGCs, with a sensitivity and specificity of 65.0% and 85.2%, respectively.F-FDG uptake by EGC depends on location, gross type, size, and depth of invasion of the primary tumor. A clinical scoring system based on clinicopathologic variables can predict the FDG-avidity of primary tumors in patients with EGC.

Backgrounds: We evaluated the prognostic value of the intratumoral heterogeneity of (18) F-FDG uptake in oral cavity cancer., Materials and Methods: We enrolled 45 patients who underwent pretreatment (18) F-FDG PET/CT. The intratumoral heterogeneity of (18) F-FDG uptake was represented as the heterogeneity factor (HF), defined as the derivative (dV/dT) of a volume-threshold function for a primary tumor. We measured the maximum standardized uptake value (SUVmax ) and volumetric PET parameters. The relationship between HF and clinical parameters, as well as other PET parameters, was evaluated., Results: The HF was significantly correlated with SUVmax (r = -0.353, P = 0.017), metabolic tumor volume (r = -0.708, P < 0.0001), and total lesion glycolysis (r = -0.709, P < 0.0001). A multivariate analysis revealed not only cervical lymph node metastasis (hazard ratio = 5.983; P = 0.022) but also HF (hazard ratio = 2.49 × 10(-4) ; P = 0.002) to be independent predictors of overall survival. Those patients with HF < -0.13 showed a worse prognosis than those with HF ≥ -0.13 (P = 0.005)., Conclusions: The intratumoral heterogeneity of (18) F-FDG uptake may be a significant prognostic factor for overall survival in addition to cervical lymph node metastasis in oral cavity cancer. J. Surg. Oncol. 2014 110:702-706. © 2014 Wiley Periodicals, Inc., (© 2014 Wiley Periodicals, Inc.)

We report a case of isolated splenic metastasis from ovarian cancer detected with 18F-FDG PET/CT. A 66-year-old woman with ovarian cancer was referred for 18F-FDG PET/CT to determine the cause of elevated serum CA-125 levels about 48 months after surgery. 18F-FDG PET/CT showed focal, intense uptake in the spleen, with no other abnormal findings. A splenectomy was performed, and the lesion was confirmed as metastasis from ovarian cancer pathologically.

Mediastinal inflammatory pseudotumor is a rare benign disease with its capability for local invasion and rapid growth. We present a case of middle-mediastinal inflammatory pseudotumor and report its contrast-enhanced chest computed tomography, (18)F-fluorodeoxyglucose positron emission tomography/computed tomography and pathologic findings.

Objective: It is known that the poor image quality of (18)F-fluorodeoxyglucose ((18)F-FDG) PET scans leads to interpretation difficulty in patients with uncontrolled diabetes mellitus (DM). We usually delay (18)F-FDG PET examination when patients show high glucose levels. This study was performed to evaluate the usefulness and effects of ultrashort-acting insulin on (18)F-FDG PET/computed tomography (CT) imaging in DM patients., Materials and Methods: A total of 105 DM patients (68 men and 37 women) were included. Ultrashort-acting insulin was intravenously injected when patients showed high glucose levels (>190 mg/dl). (18)F-FDG was injected 60 min after ultrashort-acting insulin injection, and PET/CT images were acquired. Image quality was graded by consensus using the following scale: 1, good; 2, moderate; and 3, poor. The mean standardized uptake value (SUV(mean)) of the liver, gluteal muscle, and brain was assessed to evaluate the effects of ultrashort-acting insulin., Results: The group administered ultrashort-acting insulin (n=52, blood glucose level: 243.7 ± 46.2 mg/dl) showed a significantly higher glucose level compared with the group not administered ultrashort-acting insulin (n=53, 177.1 ± 5.2 mg/dl). Nevertheless, the image quality of the group with ultrashort-acting insulin was not significantly different from that of the group without ultrashort-acting insulin (χ(2) -test, P=0.47). No significant differences were seen in SUV(mean) in the liver (P=0.13), gluteal muscle (P=0.71), and brain (P=0.16) between groups., Conclusion: Ultrashort-acting insulin can be used to improve the image quality of F-FDG PET/CT in uncontrolled DM patients without significant differences in SUV.